Opioid Equianalgesic Doses

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OPIOID EQUIANALGESIC DOSES

All equivalencies should be considered approxi-
mations only and can be affected by interpatient
variability, type of pain (ie, acute vs. chronic),
chronic administration, tolerance, etc. Patients
should be monitored for efficacy and adverse
reactions and the dose adjusted accordingly.

Generic Dose Equal to 10mg IM
of Morphine Sulfate
Oral Injection (IM/IV/SC)1
morphine2 30mg (60mg) 10mg
codeine 180–200mg 130mg
fentanyl3 N/A 0.1mg (100mcg)
hydrocodone4 30mg N/A
hydromorphone 7.5mg 1.5mg
levorphanol 4mg 2mg
meperidine 300mg 100mg
methadone 10–20mg 5–10mg
oxycodone IR 20–30mg N/A
oxycodone CR 40mg N/A
oxymorphone 10mg N/A
NOTES

Key: CR=controlled-release; IR=immediate-release

1Although controlled studies are not available, in clinical practice it is customary to consider the doses of opioids given IM, IV, or SC to be equivalent. There may be some differences in pharmacokinetic parameters such as Cmax and Tmax.

 

2The conversion ratio of 10mg parenteral morphine = 30mg oral morphine is based on clinical experience in patients with chronic pain. The conversion ratio of 10mg parenteral morphine = 60mg oral morphine is based on a potency study in acute pain.

3See literature for conversion of fentanyl transdermal patch, buccal tablets, buccal soluble film, sublingual tablets, units for transmucosal administration, and nasal spray.

4Hydrocodone not available as a single entity product.

REFERENCE

Feldman MD, Christensen JF, Satterfield JM. Behavioral Medicine: A Guide For Clinical Practice, Fourth Edition. New York, NY: McGraw-Hill Education; 2014.

(Rev. 6/2018)

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